Harnessing the Potential to Quantify Public Preferences for Healthcare Priorities through Citizens’ Juries

Document Type: Perspective

Authors

1 School of Pharmacy, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, Queensland, Australia; and Population and Social Health Research Program, Griffith Health Institute, Griffith University, Logan campus, University Drive, Meadowbrook, Queensland, Australia

2 Urban Research Program, Griffith School of Environment, Griffith University, Gold Coast campus, Southport, Queensland, Australia

3 Centre of National Research on Disability and Rehabilitation, Population and Social Health Research Program, Griffith Health Institute, Griffith University, Logan campus, University Drive, Meadowbrook, Queensland, Australia

4 Flinders Health Economics Group, School of Medicine, Flinders University, Adelaide, Australia

5 Menzies Centre for Health Policy, School of Public Health, University of Sydney, New South Wales, Australia

6 Division of Health and Social Care Research, King’s College School of Medicine, London, UK

7 Centre for Applied Health Economics, Population and Social Health Research Program, Griffith Health Institute, Griffith University, Logan campus, University Drive, Meadowbrook, Queensland, Australia

Abstract

Despite progress towards greater public engagement, questions about the optimal approach to access public preferences remain unanswered. We review two increasingly popular methods for engaging the public in healthcare priority-setting and determining their preferences; the Citizens’ Jury (CJ) and Discrete Choice Experiment (DCE). We discuss the theoretical framework from which each method is derived, its application in healthcare, and critique the information it can provide for decision-makers. We conclude that combining deliberation of an informed public via CJs and quantification of preferences using DCE methods, whilst it remains to be tested as an approach to engaging the public in priority-setting, could potentially achieve much richer information than the application of either method in isolation.

Keywords

Main Subjects


  1. Caddy J, Vergez C. Citizens as Partners: Information, Consultation and Public Participation in Policy-Making. Paris: Organisation for Economic Cooperation and Development; 2001.
  2. Mitton C, Smith N, Peacock S, Evoy B, Abelson J. Public participation in health care priority setting: A scoping review. Health Policy 2009; 91: 219-28. doi: 10.1016/j.healthpol.2009.01.005
  3. Abelson J, Giacomini M, Lehoux P, Gauvin FP. Bringing ‘the public’ into health technology assessment and coverage policy decisions: from principles to practice. Health Policy 2007; 82: 37-50. doi: 10.1016/j.healthpol.2006.07.009
  4. Rowe G, Frewer LJ. A typology of public engagement mechanisms. Science, Technology & Human Values 2005; 30: 251-90. doi: 10.1177/0162243904271724
  5. Institute for Local Government. Principles of Local Government Public Engagement [internet]. Sacramento, California 2012 [cited 2012 Feb 26]. Available from: http://www.ca-ilg.org/publicengagementprinciples
  6. Bridges JF, Jones C. Patient-based health technology assessment: a vision of the future. Int J Technol Assess Health Care 2007; 23: 30-5. doi: 10.1017/s0266462307051549
  7. Facey K, Boivin A, Gracia J, Hansen HP, Lo Scalzo A, Mossman J, et al. Patients’ perspectives in health technology assessment: a route to robust evidence and fair deliberation. Int J Technol Assess Health Care 2010; 26: 334-40. doi: 10.1017/s0266462310000395
  8. Gagnon MP, Desmartis M, Lepage-Savary D, Gagnon J, St-Pierre M, Rhainds M, et al. Introducing patients’ and the public’s perspectives to health technology assessment: A systematic review of international experiences. Int J Technol Assess Health Care 2011; 27: 31-42. doi: 10.1017/s0266462310001315
  9. Ryan M, Scott DA, Reeves C, Bate A, van Teijlingen ER, Russell EM, et al. Eliciting public preferences for healthcare: a systematic review of techniques. Health Technol Assess 2001; 5: 1-186.
  10. Wiseman V, Mooney G, Berry G, Tang KC. Involving the general public in priority setting: experiences from Australia. Soc Sci Med 2003; 56: 1001-12.  doi: 10.1016/S0277-9536(02)00091-6
  11. Scuffham PA, Whitty JA, Mitchell A, Viney R. The use of QALY weights for QALY calculations: a review of industry submissions requesting listing on the Australian Pharmaceutical Benefits Scheme 2002-4. Pharmacoeconomics 2008; 26: 297-310. doi: 10.2165/00019053-200826040-00003
  12. Dolan P, Shaw R, Tsuchiya A, Williams A. QALY maximisation and people’s preferences: a methodological review of the literature. Health Econ 2005; 14: 197-208. doi: 10.1002/hec.924
  13. Whitty JA, Lancsar E, Rixon K, Golenko X, Ratcliffe J. A systematic review of stated preference studies reporting public preferences for healthcare priority setting. Patient 2014; forthcoming. doi: 10.1007/s40271-014-0063-2
  14. de Bekker-Grob EW, Ryan M, Gerard K. Discrete choice experiments in health economics: a review of the literature. Health Econ  2012; 21: 145-72. Doi: 10.1002/hec.1697
  15. Mullen PM. Public involvement in health care priority setting: an overview of methods for eliciting values. Health Expect 1999; 2: 222-34. doi: 10.1046/j.1369-6513.1999.00062.x
  16. Menon D, Stafinski T. Engaging the public in priority-setting for health technology assessment: findings from a citizens’ jury. Health Expect 2008; 11: 282-93. doi: 10.1111/j.1369-7625.2008.00501.x
  17. Mooney G. A Handbook on Citizens’ Juries with Particular Reference to Health Care [internet].  2010 [cited 2010 July 27]. Available from: http://www.gavinmooney.com
  18. Coote A, Lenaghan J. Citizens’ Juries: Theory into Practice. London: Institute for Public Policy Research; 1997.
  19. Moretto N, Kendall E, Whitty J, Byrnes J, Hills AP, Gordon L, et al. Yes, the government should tax soft drinks: findings from a citizens’ jury in australia. Int J Environ Res Public Health 2014; 11: 2456-71. doi: 10.3390/ijerph110302456
  20. The Jefferson Center. Citizens Jury Handbook [internet]. The Jefferson Center for New Democratic Processes, 2004 [cited 2011 21 November].  Available from: http://jefferson-center.org/wp-content/uploads/2012/10/Citizen-Jury-Handbook.pdf
  21. Lancsar E, Louviere J. Conducting discrete choice experiments to inform healthcare decision making: A user’s guide. Pharmacoeconomics 2008; 26: 661-77. doi: 10.2165/00019053-200826080-00004
  22. Littlejohns P. The Citizens Council. In: Towse A, C Pritchard, N Devlin, editors. Cost-effectiveness Thresholds: Economic and Ethical Issues. London: Kings Fund: Office of Health Economics; 2002. p. 104-6.
  23. Davies C, Wetherell M, Barnett E, Seymour-Smith S. Opening the Box: Evaluating the Citizens Council of NICE. Report. Milton Keynes: The Open University; 2005.
  24. Smith G, Wales C. Citizens’ Juries and Deliberative Democracy. Polit Stud (Oxf) 2000; 48: 51-65. doi: 10.1111/1467-9248.00250
  25. Fishkin J. The Voice of the People: Public Opinion and Democracy. New Haven: Yale University Press; 1997.
  26. Somin I. When Ignorance Isn’t Bliss: How political ignorance threatens democracy. Policy Analysis No 525. Washington DC: Cato Institute; 2004.
  27. Iredale R, Longley M, Thomas C, Shaw A. What choices should we be able to make about designer babies? A Citizens’ Jury of young people in South Wales. Health Expect 2006; 9: 207-17. doi: 10.1111/j.1369-7625.2006.00387.x
  28. National Health and Hospitals Reform Commission. A Healthier Future for all Australians: Final Report. Canberra: Australian Government; 2009. doi: 10.1037/e506792012-001
  29. Rogers WA, Street JM, Braunack-Mayer AJ, Hiller JE. Pandemic influenza communication: views from a deliberative forum. Health Expect 2009; 12: 331-42. doi: 10.1111/j.1369-7625.2009.00562.x
  30. Mooney GH, Blackwell SH. Whose health service is it anyway? Community values in healthcare. Med J Aust 2004; 180: 76-8.
  31. Paul C, Nicholls R, Priest P, McGee R. Making policy decisions about population screening for breast cancer: the role of citizens’ deliberation. Health Policy 2008; 85: 314-20. doi: 10.1016/j.healthpol.2007.08.007
  32. Mills JS. On Liberty. London: Parker; 1859.
  33. Dahl RA. On Democracy. New Haven: Yale University Press; 1998.
  34. Marshall D, Bridges JFP, Hauber B, Cameron R, Donnalley L, Fyie K, et al. Conjoint analysis applications in health - How are studies being designed and reported? Patient 2010; 3: 249-56. doi: 10.2165/11539650-000000000-00000
  35. Manski CF. The structure of random utility models. Theory Decis 1977; 8: 229-54. doi: 10.1007/bf00133443
  36. McFadden D. Conditional logit analysis of qualitative choice behaviour. In: Zarembka P, editor. Frontiers in Econometrics. New York: Academic Press; 1974. p. 105-42.
  37. Thurstone L. A law of comparative judgement. Psychol Rev 1927; 4: 273-86. doi: 10.1037/h0070288
  38. Lancaster K. A new approach to consumer theory. J Polit Econ 1966; 74: 132-57. doi: 10.1086/259131
  39. Ryan M. Discrete choice experiments in health care. BMJ 2004; 328: 360-1. doi: 10.1136/bmj.328.7436.360
  40. Ratcliffe J. Public preferences for the allocation of donor liver grafts for transplantation. Health Econ 2000; 9: 137-48. doi: 10.1002/(sici)1099-1050(200003)9:2%3C137::aid-hec489%3E3.3.co;2-t
  41. Green C, Gerard K. Exploring the social value of health-care interventions: a stated preference discrete choice experiment. Health Econ 2009; 18: 951-76. doi: 10.1002/hec.1414
  42. Whitty JA, Scuffham PA, Rundle-Thiele SR. Public and decision maker stated preferences for pharmaceutical subsidy decisions: a pilot study. Appl Health Econ Health Policy 2011; 9: 73-9. doi: 10.2165/11537150-000000000-00000
  43. Whitty JA, Ratcliffe J, Chen G, Scuffham PA. Australian Public Preferences for the Funding of New Health Technologies: A Comparison of Discrete Choice and Profile Case Best Worst Scaling Methods. Med Decis Making 2014; forthcoming. doi: 10.1177/0272989x14526640
  44. Schwappach DLB. Does it matter who you are or what you gain? An experimental study of preferences for resource allocation. Health Econ 2003; 12: 255-67. doi: 10.1002/hec.713
  45. Scuffham PA, Whitty JA, Taylor M, Saxby R. Health system choice: A pilot discrete choice experiment eliciting the preferences of British and Australian citizens.  Appl Health Econ Health Policy 2010; 8: 89-97. doi: 10.2165/11531170-000000000-00000
  46. Gyrd-Hansen D, Slothuus U. The citizen’s preferences for financing public health care: a Danish survey. Int J Health Care Finance Econ 2002; 2: 25-36. doi: 10.1023/A:1015345429726
  47. Lancsar E, Wildman J, Donaldson C, Ryan M, Baker R. Deriving distributional weights for QALYs through discrete choice experiments. J Health Econ 2011; 30: 466-78. doi: 10.1016/j.jhealeco.2011.01.003
  48. Ryan M, Gerard K, Amaya-Amaya M. Using Discrete Choice Experiments to Value Health and Health Care. Dordrecht, Netherlands: Springer; 2008.
  49. Dolan P, Cookson R, Ferguson B. Effect of discussion and deliberation on the public’s views of priority setting in health care: focus group study. BMJ 1999; 318: 916-9. doi: 10.1136/bmj.318.7188.916
  50. Salkeld G, Ryan M, Short L. The veil of experience: do consumers prefer what they know best? Health Econ 2000; 9: 267-70. Doi: 10.1002/(sici)1099-1050(200004)9:3%3C267::aid-hec511%3E3.0.co;2-h
  51. Damschroder LJ, Pritts JL, Neblo MA, Kalarickal RJ, Creswell JW, Hayward RA. Patients, privacy and trust: patients’ willingness to allow researchers to access their medical records. Soc Sci Med 2007; 64: 223-35. doi: 10.1016/j.socscimed.2006.08.045
  52. Goold SD, Biddle AK, Klipp G, Hall CN, Danis M. Choosing Healthplans All Together: a deliberative exercise for allocating limited health care resources. J Health Polit Policy Law 2005; 30: 563-601.